Socioeconomic factors affecting psychotherapy use rates

Abstract Objectives Previous studies indicate socioeconomic inequalities in psychotherapy utilization. The aim of this study was to assess the associations of individual annual incomes with the utilization of long-term rehabilitative psychotherapy during nine-year follow-up in men and women. As secondary analyses we assessed the association of main activity with the utilization of psychotherapy. Methods For this study, we selected those from a random sample of the working-age population (18-55 years) with information about income at each time point during the follow-up from 2011 to 2019 (N = 736 613). Psychotherapy usa during the follow-up period served as dependent variable and sosiodemographic variables, annual incomes and main activity (employed, unemployed, studying, other) were used as independent variables. To examine change in the psychotherapy use rates over time, we used sex-stratified generalized estimating equations logistic regression models with predicted marginal probabilities. Results Psychotherapy use rate was constantly higher among women than in men (in 2011 0.8% and 0.2%) and increased from 2011 to 2019 among both genders and income quartiles (among women 174% - 231% and among men 213% - 248% increase between quartiles). Among men, psychotherapy use rate was highest among lowest income quartile throughout the study interval. Among women such difference was not observed. Among women, studentś psychotherapy use increased significantly when compared to other groups from 2011 to 2019 (299% increase vs 89% - 210% increase among other groups). A similar pattern was seen among studying men versus other groups. Conclusions Between 2011 and 2019 the probability of having psychotherapy increased among both genders. Unexpectedly, pro-rich psychotherapy use rate was not observed. The highest probability to use psychotherapy in lowest income quartile might be linked with differences in health care systems for students and for other.


Introduction:
The concept of health capital views health as a form of capital that produces healthy time to individual. This stock of capitalhealth that is -can decrease or increase. The potential of psychotherapy as individual's investment to (mental) health capital has been rarely studied in population level.

Objectives:
The aim of our study is to shed light on the returns on individual-level investments in health capital. We consider the use of psychotherapy as an investment in health capital. This investment offers potential returns for individual as a higher level of subsequent income. However, these returns are potentially heterogenous: we aim to show to whom the use of psychotherapy is a sound investment in health capital.

Methods:
We model the effects of mental health, and subsequent treatments such as the use of psychotropics and psychotherapy on income using two-way fixed effects regression.

Results:
Preliminary results show that different parts of working-age population seem to have different potential returns related to the use of psychotherapy. These heterogenous effects are related to previously reported socioeconomic status related disparities: the level of human capital i.e. income and education play a role in the profitability of the individual level investment made in the health capital by the use of psychotherapy.

Conclusions:
The use of psychotherapy has heterogenous effects on the income of individuals. The potential of this investment to produce health capital varies with education, the level of income prior to the use of psychotherapy.

Objectives:
Previous studies indicate socioeconomic inequalities in psychotherapy utilization. The aim of this study was to assess the associations of individual annual incomes with the utilization of long-term rehabilitative psychotherapy during nine-year follow-up in men and women. As secondary analyses we assessed the association of main activity with the utilization of psychotherapy.

Methods:
For this study, we selected those from a random sample of the working-age population (18-55 years) with information about income at each time point during the follow-up from 2011 to 2019 (N = 736 613). Psychotherapy usa during the follow-up period served as dependent variable and sosiodemographic variables, annual incomes and main activity (employed, unemployed, studying, other) were used as independent variables. To examine change in the psychotherapy use rates over time, we used sex-stratified generalized estimating equations logistic regression models with predicted marginal probabilities.

Results:
Psychotherapy use rate was constantly higher among women than in men (in 2011 0.8% and 0.2%) and increased from 2011 to 2019 among both genders and income quartiles (among women 174% -231% and among men 213% -248% increase between quartiles). Among men, psychotherapy use rate was highest among lowest income quartile throughout the study interval. Among women such difference was not observed. Among women, studentś psychotherapy use increased significantly when compared to other groups from 2011 to 2019 (299% increase vs 89% -210% increase among other groups). A similar pattern was seen among studying men versus other groups.

Conclusions:
Between 2011 and 2019 the probability of having psychotherapy increased among both genders. Unexpectedly, pro-rich psychotherapy use rate was not observed. The highest probability to use psychotherapy in lowest income quartile might be linked with differences in health care systems for students and for other.

Introduction:
Previous studies have shown the effects of occupational class and gender on mental distress and use of psychotherapy. However, less is known about the mental distress-based use of psychotherapy in different occupational classes.

Objectives:
The aim of our study is to show how the prevalence of mental distress and the use of long-term psychotherapy correlates in different occupational classes by gender. Methods: Data were drawn from the Rise of Mental Vulnerability Study (psychotherapy) and FinHealth 2017 Study (mental distress). Adjusting for age, we calculated GHQ caseness, psychotherapy use rate, and the ratio between GHQ caseness and psychotherapy use rate in three occupational classes (upper non-manual employees, lower non-manual employees, and manual workers) separately for men and women. Age-adjustment was performed through regression analysis by using model generated predicted values of GHQ caseness and psychotherapy use rate at the average sample age of 40.

Results:
In the group of upper non-manual men there were 10 persons with severe mental distress for every single person having used psychotherapy. For lower non-manual men and manual male 15th European Public Health Conference 2022 iii279